Bruce Gragg Blackstone, M.D.

NPI #1891760211 in Longview, Washington

Provider Information

NPI Number: 1891760211
Entity Type: Individual
Name: Bruce Gragg Blackstone, M.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Orthopaedic Surgery
Credential: M.D.
Enumeration Date: Feb 20, 2006
Last Updated: Sep 22, 2010

Practice Location

Address: 625 9TH AVE
Address 2: SUITE 210
City: Longview
State: Washington
ZIP Code: 98632-2465
Phone: (360) 501-3400

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Orthopaedic Surgery	207X00000X	Primary

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